DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Black, Kris A	DOIID	762036	NAIC NPN	16239376

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	8/26/2011	1/31/2019
Inactive	Non Resident	Agent	Life	8/26/2011	1/31/2019
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American General Life Insurance Company	301585	Agent - Health	8/29/2012	1/31/2019
Inactive	American General Life Insurance Company	301585	Agent - Life	8/29/2012	1/31/2019
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	11/14/2014	10/28/2015
Inactive	Fidelity Life Association, A Legal Reserve Life Insurance Company	300774	Agent - Life	9/6/2011	12/5/2018
Inactive	Lumico Life Insurance Company	300354	Agent - Health	12/20/2018	1/31/2019
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	10/19/2011	11/14/2014
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	5/4/2018	12/5/2018
Inactive	North American Company for Life and Health Insurance	300291	Agent - Life	4/25/2015	2/15/2018
Inactive	Omaha Insurance Company	751908	Agent - Health	5/4/2018	8/8/2018
Inactive	Pruco Life Insurance Company	300954	Agent - Health	9/22/2011	12/12/2018
Inactive	Pruco Life Insurance Company	300954	Agent - Life	9/22/2011	12/12/2018
Inactive	Revol One Insurance Company	300681	Agent - Life	9/2/2011	5/31/2012
Inactive	United World Life Insurance Company	300532	Agent - Health	5/4/2018	12/5/2018
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	5/4/2018	12/5/2018
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	5/4/2018	12/5/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Efinancial LLC	598419	Agent - Life	11/3/2011	1/31/2019
Inactive	Efinancial LLC	598419	Agent - Health	11/3/2011	1/31/2019